Good Afternoon Drs. H/H,
My wild journey into dating again after 17 years continues. I thankfully have tested negative, after some vaginal symptoms, for all STDs (HIV, syphillis, Chlamydia, Gon, mycoplasma gen) and it was found after a more extensive vaginal test that I did have Garderella--a lower bacterial load that was not triggering positive tests, but high enough that my OBGYN was sure it was causing me some discomfort (just to give you the outcome of my previous post which was a mystery for some time). I was treated with boric acid and am doing a once per week metro gel treatment for 12 weeks. Already feeling 100x better!

The plot thickens, though as I just had my scheduled pap smear for 2024, my last one being 2021. I've never, ever had an abnormal pap, and got a call yesterday that I came back positive for HPV-18 and ASCUS. As much as I know about HPV, this was still of course upsetting, alarming and I came directly here to read your many threads on the subject. From what I gather, and I'm already feeling some relief, both of you feel that even with the higher risk HPV-18, it is still likely I'll clear the virus myself with virtually no complications. One thing I couldn't find though, was what your thoughts are on if there is a family history of cervical cancer in a woman's family. My mother, grandmother and a maternal cousin ALL were diagnosed with either pre-cancerous or full blown cancerous cells needing freezing or other treatments. Do you feel this changes my odds at all? I should mention all three were extremely heavy smokers which I know is a huge factor for cervical cancer. I am not and never have been. I have an apt for the colposcopy in less than 2 weeks and am so anxious to get this going. Thank you again for the forum, it helped me to sleep last night! Any insight/thoughts from either of you would just be so amazing.

Welcome back. It's great to hear your vaginal symptoms are doing well. Interesting about Gardnerella and the nice response to metronidazole plus boric acid. As your gyn may have discussed with you, Gardnerella vaginalis is normal in the vagina, but higher than usual levels are associated with (and can help diagnose) bacterial vaginosis. BV doesn't usually cause the irritating symptoms you had, and I'm still inclined to believe the problem was essentially one of vaginal microbiome adjustment related to resumption of sexual activity with a new partner. Whatever the explanation, there's no arguing with treatment success!---
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Thank you so much Dr H. I didn't ask about the origin because I have learned enough from you and this forum, plus previous forums that you've been on, that frankly, given my history of partners, this absolutely was probably a reactivation. Given this partner is well into his forties and this relationship is so new, I am also doubtful it's from him. Of course like you say, it's possible, but it doesn't really matter at this point and seems to be a moot point to focus on! As you've said many times...if there was a stadium of 100,000 women, 90,000 would be somehow affected from HPV, a natural consequence of sexual activity. 

It's so good to hear a balanced, intelligent, and informed replies from a forum user! Even a cursory scan reveals it isn't always that way. I'm very glad you understand about HPV risks etc. And I never considered your symptoms "bonkers", and I have no doubt that you definitely have treated something that was significant, at least from a symptomatic standpoint even if not caused by a clearly recognized pathogen. Anyway, situations like yours aren't all that rare. We in the STD genital health business like to classify lower genital tract infections in women according to standard categories (BV, yeast, UTI, cervicitis, trichomonas, and traditional STDs like gonorrhea and chlamydia) -- but probably 20% of cases don't fall cleanly into any of those categories-- often frustrating for both affected women and their doctors. The main thing is that your treatment worked!---

Thank you again so much for your help Dr. H. As my final follow up, I was wondering what your thoughts are on my getting an HSV1/2 test as a last resort/peace of mind for some of the symptoms I was having. I know those symptoms would be completely atypical, but not impossible... I've read a recent study where they found a small sample of women only experiencing discharge/cervicitis to be positive for HSV-2. As I've just tested negative for nearly everything else, I can't get rid of this nagging feeling of just getting the testing done to add to my "ruled out" category. I am super aware of the possible false negatives, but I can't help but have it pull at me to just do it for peace of mind. I of course have never had any outbreaks of any kind, or anything remotely close to HSV-2 (I could care less about HSV-1 frankly) symptoms like the acute swelling glands, sore throat, horrific first outbreak or any subsequent outbreak. Stupid? Worth it? Your answer will be close this thread!

Don't do it. The HSV blood tests simply are not accurate enough, with frequent misleading results. Without typical symptoms of infection, I wouldn't trust a positive result, nor would a negative test conclusively exclude the presence of herpes.---

To clarify a bit more before closing the thread:  If you test for HSV2, probably it will be negative and reassuring. If clearly positive, it would be distressing, but at least you would know and take steps to protect your partners' health. The main problem arises if you have a low positive result, which is a quite common test result. At a minimum, it can be a hassle (and expensive) to sort out whether or you are actually infected, and sometimes it simply isn't possible to know with complete certainty. I don't think you'd like to find yourself in that situation.---